The Biomedical Imaging and Visualization Project was previously known as the TELESYNERGY(R) Medical Consultation WorkStation (MCWS) Environment. The name change of the Project, and our section, appropriately reflects the fact that the scope of the project has gradually expanded over the years.[unreadable] [unreadable] Development of the MCWS was initially begun by CBEL in the mid 1990s, and it was first deployed in the Center for Information Technology (CIT) and NCI Radiation Oncology Branch (ROB) environments on the NIH campus in 1995 and 1997, respectively.[unreadable] [unreadable] The National Cancer Institutes Radiation Oncology Sciences Program (ROSP) is: (1) sponsor of a clinical outreach program (Partnerships in Science(TM), (2) participant in a residency training program jointly with the Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC), (3) participant in the NCI All Ireland Cancer Consortium (combining the cancer treatment capabilities of Bethesda, Belfast, and Dublin in a five-year relationship aimed at a multilevel attack on cancer in Ireland), and finally, (4) supportive of the re-vitalization of the King Hussein Cancer Center (KHCC) in Amman Jordan. The TELESYNERGY(R) System quickly became a major IT component of these programs through NCI and CIT Collaboration.[unreadable] [unreadable] The MCWS allows real-time multimedia conferencing between distributed sites, and the systems include high-resolution electronic view boxes for the display of CT, MRI or chest film images. Also included is a high-resolution video link for the presentation of a view of the consultant, the display of videotaped medical images or live presentations, or the display of histopathology images obtained from remote-controlled microscopes. As a component of this project, a prototype high-speed medical image communication network was implemented, based on 155 Mb/sec ATM Switch technology. The MCWS System originally allowed ATM/ISDN Gateway access to remote/distant sites via high-speed ISDN Primary Rate Interface (PRI) Telephone Circuits. Currently, all communication between MCWS Sites occurs over ISDN PRI Circuits.[unreadable] [unreadable] The NCI selected the TELESYNERGY(R) System as the enabling technology for their Partnerships in Science(TM) Program, and the first of these partnerships sites to be implemented with the TELESYNERGY(R) System was the Holy Cross Hospital, in Fort Lauderdale, Florida, during the Summer of FY00. A TELESYNERGY(R) System was installed at the WRAMC in April of FY01, and an upgraded version was installed during the last quarter of FY04. A second Partnerships in Science(TM) site, the Schiffler Cancer Center at the Wheeling Hospital, in Wheeling, West Virginia, had its TELESYNERGY(R) System installation completed during January of FY02.[unreadable] [unreadable] In addition, full TELESYNERGY(R) systems were implemented at the Belfast City Hospital in Belfast, N.I., U.K., and at the St. Luke's Hospital in Dublin, Republic of Ireland (ROI), during the summer of FY02. A second ROI system was installed at the Trinity College Dublin (TCD) at the School of Radiation Therapy in February of FY04. Full TELESYNERGY(R) Systems were installed at Cork University Hospital and the University College Hospital Galway during the winter of FY06. In addition, a simplified and upgradeable TELESYNERGY(R)-Lite System was installed at the same time, within TCD, as a sample for duplication at five smaller cancer centers in the ROI by TCD Staff.[unreadable] [unreadable] Since September 1999, we had been planning for the installation of a TELESYNERGY(R) System within the King Hussein Cancer Center (KHCC) in Amman, Jordan, as part of an NCI-Jordan Cancer Consortium. The installation of this most advanced TELESYNERGY(R) System, was successfully completed during January of FY04. Another TELESYNERGY(R) System was installed in the Clinical Centers re-designed 11th floor Telemedicine Clinic during the summer of FY04. Currently, a total of eleven full TELESYNERGY(R) Systems have been installed worldwide, and are supported by CIT staff. Additional systems of various designs and running commercial software (twelve in the U.S. and one in Belgium) are supported by NCI staff.[unreadable] [unreadable] Completed during FY07, was the task of converting the CIT-developed TELESYNERGY(R) Software from its original Sun/Solaris workstation environment to the PC/Linux workstation environment. Also completed was the integration and packaging of all hardware components for the portable and ruggedized version of the TELESYNERGY(R) environment, including its Very Small Aperture Terminal (VSAT) Satellite Antenna System.[unreadable] [unreadable] During FY07, BIVS developed a small Telenephrology System on a mobile cart that provides Dr. Andrew Narva (NIDDK), the newly-appointed Director of the National Kidney Disease Education Program, with the ability to conduct regularly scheduled clinics with his previous renal patients at the Zuni PHS Hospital in Zuni, AZ. In addition, BIVS implemented an EENT Imaging System on a mobile cart for Dr. Hirsh Komarow (NIAID), Staff Clinician in the Laboratory of Allergic Disease, for his use in the NIAID Pediatric Allergy Clinic.[unreadable] [unreadable] During November and December, in FY08, a full TELESYNERGY(R) System was deployed within the U.S. Army's Telemedicine and Advanced Technology Research Center (TATRC) at Fort Detrick, MD, in order to allow TATRC Staff to evaluate the TELESYNERGY(R) Environment.[unreadable] [unreadable] An additional full TELESYNERGY(R) System was commissioned at the Beaumont Hospital in Dublin, Republic of Ireland in August 2008. This was the sixth full TELESYNERGY(R) System installed in Ireland under the NCI All Ireland Cancer Consortium umbrella.[unreadable] [unreadable] Also, during FY08, efforts have continued on the development of algorithms in support of MRI Diffusion Tensor Imaging (DTI) research, in collaboration with Peter J. Basser, Ph.D., NIH Senior Investigator and Chief, Section on Tissue Biophysics and Biomimetics, NICHD, and members of his Section. These activities include development of tissue classification algorithms for DTI data, development of novel pulse-programming sequences, design of a diffusion magnetic resonance microscopy experiment for adult Zebrafish, and development of various additional image processing algorithms.[unreadable] [unreadable] In addition, the development of an automated Organ and Lesion Volume Calculation Server was initiated, at the request of Ronald M. Summers, M.D., Ph.D., Chief, Image Processing Group, Department of Radiology and Imaging Sciences, CC. While the eventual goal is fully unattended calculation of designated organ and lesion volumes, our prototype is being developed as an operator-assisted system that will allow the calculation of gold standard volume values. Future versions of this system will have their calculated volumes compared against the gold standard volume values obtained from test image sets, in order to validate the fully automated system.[unreadable] [unreadable] Finally, in FY08, the development of a unique 3D Medical Imaging System was initiated. The hardware design was completed for this Stereo Medical Image Display System, which will be controlled by hand-motion via a Haptics Glove. The hardware components have been procured, and component delivery was almost complete. The software environment was generally specified, with a principal element expected to be the CIT-developed MIPAV Image Processing Environment.[unreadable] [unreadable] During FY09, the prototype Organ and Lesion Volume Calculation Server will continue to be developed. In addition, application software to detect and interpret hand gestures, for the 3D Medical Image Display System, will be specified. Intersecting trade-offs will be considered between Build vs. Buy, and Simple vs. Complex gesture recognition.